Formación continuada y continuidad en la habilitación / Continuing training and continuity in training

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Sarcoma de Monte de Venus: una presentación infrecuente / Testicular germ-cell tumor in two siblings: a propos of a new case

Los sarcomas de partes blandas son raros. Tan sólo representan el 0,7 por ciento de los tumores malignos en el adulto, y el 1-3 por ciento de los tumores de vulva. Embriológicamente derivan del mesenquima primitivo y pueden asentar en cualquier parte del organismo.Existe gran variedad de tipos histológicos con más de 30 subtipos, siendo difícil la distinción entre ellos.A propósito de un caso de sarcoma en el Monte de Venus tratado en nuestro servicio realizamos una revisión de la bibliografía existente (AU)

Marcadores tumorales procesos ginecológicos benignos / Tumor markers in benign gynecologic diseases

La determinación de marcadores tumorales se emplea como prueba complementaria en el diagnóstico de algunas neoplasias. Cifras muy elevadas se asocian casi invariablemente a neoplasias malignas. Presentamos el caso de una paciente en la que el conjunto de datos analíticos, sobre todo la importante elevación de marcadores tumorales, y exploratorios orientaron hacia un diagnóstico de malignidad que condujo a la realización de cirugía radical. Únicamente el estudio histopatológico diferido de toda la pieza demostró la benignidad del proceso. Tras el tratamiento los niveles de marcadores descendieron hasta su normalización. Se concluye que la presencia de marcadores tumorales muy elevados puede inducir a un diagnóstico erróneo de malignidad en el estudio de las masas ováricas (AU)

[Infant mortality and sudden infant death in Navarra between 1985 and 1996]. / Mortalidad infantil y mortalidad por muerte súbita infantil en Navarra 1985-1996.

OBJECTIVE: The objective of this study was to obtain an accurate register of the deaths of children less than one year of age in order to discover the real infant mortality (IM) rate in Navara and its trend during the period between 1985 and 1996, a well as to investigate the deaths by sudden infant death (SID) in the same period and their relationship to the prone position during sleep. PATIENTS AND METHODS: Infant mortality was determined by detailed examination of all certified deaths. Research into possible nonregistered deaths was also carried-out. The sources of information included the archives and registers of the pediatric and obstetric wards and pathology departments of all hospitals. Deaths codified as 798.0 (CIE9 infinity R) were included in the study as death by SID. To determine sleeping posture. In the second semester of 1996, a survey was carried out on a sample of 285 children of under 6 months of age. The survey's model is the same as that published previously. RESULTS: In the period of 1985 to 1992, IM was 12.33 per thousand live births. The SID rate was 1.30/1,000 live births. The prevalence of the prone position is unknown. In the period between 1993 and 1996, IM decreased to 5.84/1,000 live births and this decrease was proportional in both the neonatal and postneonatal components. The rate of SIM decreased to 0.44/1,000 live births. At the beginning of 1993, 86% of the children slept in the prone position, in 1994, 38% and in 1996, only 23%. CONCLUSIONS: Trustworthy data in Navarra shows a decrease in IM of more than 50% from 1993 on. The SID rate also decreased by 65%, coinciding with a massive drop in the use of the prone position during sleep.

Zinc concentration of amniotic fluid in the course of pregnancy and its relationship to fetal weight and length.

The interest of the zinc content of amniotic fluid and its relationship to different maternal and fetal parameters is recent. It was reported that the zinc content of amniotic fluid increases in the course of pregnancy probably as an indirect indicator of an increased rate of protein synthesis. These considerations and the known important metabolic role of zinc led us to study the zinc content of amniotic fluid and its importance in the growth and development of the fetus. Amniotic fluid samples of 24 women with normal pregnancies and normal term deliveries were studied. The samples were obtained between weeks 29 and 42 of gestation by transabdominal amniocentesis and the zinc content was determined by means of atomic absorption spectrophotometry. The zinc content of amniotic fluid increases significantly during the third trimester. A positive linear correlation was found between the zinc concentration of amniotic fluid and fetal weight and length. Fetal growth and development would depend on the zinc available due to its biological functions and thus the increase of zinc concentration of amniotic fluid in the last weeks of gestation and its correlation with fetal weight and length. These results suggest that the determination of zinc content of amniotic fluid can be useful in the assessment of fetal development and well-being, and of course of pregnancy.